Publications and Forms
A form for use by a health care provider requesting the dismissal of an application for direct payment in a workers’ compensation medical fee dispute.
A form for use by a health care provider requesting the dismissal of an application for payment of additional reimbursement of medical fees in a workers’ compensation “reasonableness” medical fee dispute.
Request to DWC for a final award hearing regarding workers compensation claim.
Request to DWC for a hardship hearing regarding workers compensation claim.
A form requesting services from a workers' compensation program or the Missouri workers' safety program.
An annual report of an individually self-insured employer’s audited financial statements.
An annual report of an individually self-insured employer’s Missouri payroll by class code and employee count by Missouri location.
An annual report of an individually self-insured employer’s Missouri compensation payments for the prior calendar year.
An annual report of an individually self-insured employer’s outstanding losses.